Jonathan Gruber and the latest con attack on Obamacare.

Every time the HateAmerica crowd thinks they’re finally going to bury the ACA they gloat. They can’t contain their joy at the prospect that millions of newly insured Americans will lose their lifeline to healthcare. We know this because they never propose solutions to the problems they claim to see in Obamacare. The final version of the ACA is arguably vague on whether those purchasing insurance on the federal exchange are eligible for subsidies.

There are two obvious solutions: 1) Cons could work with Dems to amend the ACA to clarify that subsidy eligibility does not depend on whether insurance is purchased on a state or federal exchange. 2) Cons could urge Republican-controlled states to set up ACA exchanges. But the cons don’t recommend either course because they want to hurt the 10 million+ Americans who finally have healthcare and to prevent others from getting it.

One Response to Jonathan Gruber and the latest con attack on Obamacare.

With Jonathan Gruber now apparently on a self-aggrandisement tour, it has come come again to public attention that Obamacare was a masterful piece of legislation that accomplished previously unattained health-care goals while minimizing the CBO score of its provisions as taxes. Of course, Republicans are taking some of Gruber’s less-artful remarks as an opportunity for refreshing their attack spin against Obamacare, but cooking the books is nothing new for either party (and in fairness, Obamacare provides many hidden societal & thus economic savings not possible for the CBO to score).

Another plus for Obamacare was that it was limited in its initial scope and it didn’t attempt an instant government takeover of all privately administered healthcare. Instead it poked the proverbial camel’s nose under the tent by working within the existing system setting minimum standards by which insurance companies must operate. It then provided sliding scale subsidies to make insurance affordable to those who previously often forewent insurance for financial reasons. For those with extremely low income (under 138% of the FPL), it expanded Medicaid (but SCOTUS nixed this and made it optional to each state’s legislators).

Though many Progressives wanted a “single-payer” (goverment administered insurance) or “Medicare For All”, when one considers the problems Obamacare had in implementing even its modest changes (highlighted by the healthcare.gov website failure), it becomes clear that it is fortunate that Democrats did not try to take on more all at once. If Democrats can show Obamacare is successful, this will put Republican criticisms in their place, and perhaps at a later point “Medicare For All” or a true “single-payer” option may be politically viable.

I have other concerns about taking on the public option too fast, primarily related to the quality of care. The current generally available public option is Medicaid (Medicare is not a true single-payer program). Medicaid is the public option Obamacare attempted to expand for the poor in each state. The problem is that the coverage provided & the quality of the care tends to be underwhelming. It is bare-bones coverage with many limitations that make it barely worthy of the first-world. As it pays providers very little, and typically the doctors that take it are in urban areas with sparse offices that remind one of a Greyhound bus station. Doctors must do a high volume to offset the low compensation rates, and being super-busy often leads to chronically long waits. When you do see the doctor, you may find that they barely speak your language, and they aren’t likely the most qualified (or they would be working somewhere else).

Worse, because of the low compensation rates, some Medicaid providers care less about what the patient needs and more about what services they might be able to pad your bill with that Medicaid might pay. For example, I once went to a dentist that advertised a good price on x-rays & teeth cleaning. What I got to the office, I overheard many conversations at the front desk & all seemed to involve Medi-Cal (California’s Medicaid). I had to wait in a huge unpleasant waiting room with unruly kids running all around. The teeth cleaning I got was no better than I can do myself with my WaterPick & a toothbrush. Then when the doctor came for the consultation on my X-rays, he told me he wanted to send me to his oral surgeon buddy to consider pulling my upper two front teeth because the nerves in them had receded (from years of wearing braces & accidental traumas). The doctor said that without the nerve extending normally into the teeth, it left them vulnerable to fill up with bacteria & decay & then break. Well this was perhaps thirty years ago. I still have have all my front teeth, and no other dentist has ever suggested anything was seriously wrong. I’ve talked to many on Medi-Cal (California’s Medicaid) and have heard many other similar stories suggesting malpractice and/or fraud. Thus my perspective of Medicaid & the danger presented by rushing headlong into converting our healthcare system entirely to the public option. I think if you ask around, you’ll find my evaluation of Medi-Cal/Medicaid is not far off the mark. I would certainly support “Medicare For All” long before I would consider strictly a “Medicaid” public option. Medicare is a bit of a hybrid between the extremes of the all public option & all private insurance. At the present time, it still pays providers somewhat better, though an accounting trick used in Obamacare (that hopefully is never allowed to be enacted) reduces Medicare’s provider compensations to match Medicaid’s.

Beginning ~10yrs ago, Moscow-based Kaspersky Labs tried2 damage rival competitor’s reputations by tricking their programs into classifying benign files as malicious. Per 2 former employees, some such attacks were ordered by

(Wednesday, Dec 13. 2017 12:50 AM)

KL’s co-founder Eugene Kaspersky, in part 2retaliate against rivals who he felt were aping his software rather than dev their own. KL’s engineers would take files like common critical drivers & inject bad code into them so they appeared infected. KL would then upload the doctored files anonymously2 VirusTotal flagging them as infected. Other AV engineers would then visit VT & create signatures that would flag all sim files. This often caused their AV programs 2quarantine perfectly good drivers from ppl’s computers causing system problems. http://goo.gl/fssZ1B

I guess it all boils down2 what 1 believes gives meaning to mankind’s life. To me, man will only have significance if he survives the Darwinian nature of the universe in the long term. In only a billion yrs, r sun will have brightened

(Tuesday, Dec 12. 2017 04:59 AM)

enough2 boil the oceans. If man is 2survive, it will only be cuz of his unique intelligence & ability2 fav reshape his enviro. There is nothing else particularly special about man, espec not his ability 2practice cut-throat Darwinistic behaviors. If the nat Darwinian path led2 immortal life, we would see evidence of an entire universe teaming w/life that has survived the ages. We don’t. So man must uniquely fight against the natural Darwinian order & instead build the strongest poss united society in which all individuals & earth’s life forms thrive.

4 Jeff – 1st of all u wrote that I think gov’t should buy everything 4 everybody. Obviously, that’s false. Now u write that I want gov’t 2 buy baseball tix 4 poor kids. I don’t oppose such legislation but my preference is that the City of Baltimore should condition use of its city by O’s upon an agreement by team 2 distribute free or low-cost tix to poor Baltimoreans.

For Hal – You do think the government should buy tickets to baseball games for the less fortunate. What’s the difference between that and a voucher to a restaurant? The point stands. You think the government has the authority to spend someone else’s money on whatever you deem appropriate.

For jeff linder – not everything. I don’t think the gov’t should provide people with yachts or vouchers to eat at restaurants & not at the expensive others since I would b subject 2 same taxes that I support. But it’s easier 2 attack arguments I don’t make.

The EIC has been much abused. Ppl that dont even work r propositioned by dishonest tax preparers who promise ppl they will get a tax refund if they just pay a fee. Self-Emp_Income is declared & the EIC is requested. By law, IRS pays

(Sunday, Dec 10. 2017 06:56 PM)

refunds quick, & only later it discovers the person never paid SEI taxes. The tax preparer & their fee r long gone; the person now owes IRS back the EIC. Woe 2the person that actually recvd need-based benefits (SSI or welfare) during the tax yr, as IRS records now show they had SEI they didnt declare. So welfare/SSI also want their money back, & usually such persons already at poverty level. This is the type of issue I tried 2expain2 Hal re accurate gas tax refunds. Although computerization slowly making this better, such programs rife w/fraud & bureaucratic messes.

Jeff isnt proposing a true GMI. The “earned income tax credit” he mentions already exists – IF u have low-pay job, then u may get a tax rebate. This also much like current Repub proposals 2req work 2get Medicaid. Prob socially

(Sunday, Dec 10. 2017 02:32 PM)

insulated ppl dont recog is there r many that have educational/mental/physical/economic-based issues such that they cant get/hold a job in today’s economy where workers compete w/3rd world. Sometimes ppl like Jeff will have eyes opened if something really bad happens in their lives. Gen working population is always so surprised how few services there really r when it is they that need help – but even then they often hang on2 dogma: Everybody but them (espec those dark “foreigners”) r cheaters/liars & that’s why there is nothing avail 4them when they need it.

Tweeden’s colleague John Phillips /groomed/ her 2release pic; Tweeden had no idea Phillips & Stone were hard right buddies. Arnold says Sean Hannity had wanted the photo since 2007 but she refused him & that Tweeden never wanted Franken fired. Arnold posted email purportedly showing Stone trying2 whip up story2 gossip columnists even b4 Tweeden story aired, though a pseudonym Russian nm was used & Tom has no proof email was Stone’s doing. DC & US will be vacant if we all r held 2such high stds over entire lifetime. We need Al in the Senate. http://goo.gl/oLWfA3

For halginsberg – The government spends about $1T in means tested programs. That’s about $3K per person. For illustration only:. GMI-Earned Income=Refund. That way there is no cost in benefits to working.

For halginsberg – That’s funny Hal. You think it’s someone else’s duty to spend money on things you think are important. I think you should spend your money on what you think is important. Re GMI it’s a workable solution as a replacement for all welfare programs.

For halginsberg – It’s not the federal government’s business to ensure all citizens have health care, a roof over their heads and a warm place to sleep Hal. If you know someone like in dire need why aren’t you helping them?
And yes, I support a guaranteed income.

For jeff linder – I asked u earlier how u propose to ensure all citizens have health care, a roof over their heads, and a warm place to sleep. I think u support a guaranteed minimum income. Is that correct?